Guidelines for Obtaining Services

• The planning team determines needed services.
• Services authorized for payment by the regional center will be included in the individual’s IFSP or IPP.
• Prior to authorization of regional center funding, an exploration of the availability of other funding sources is required. These sources may include private health insurance, personal resources or services available through other publicly funded agencies.
• Except as legally prohibited by the terms of a Special Needs Trust, trust funds established for the care or benefit of a person served by TCRC are considered a private resource. Trust funds shall be used prior to regional center funds.
• TCRC will help to ensure that other publicly funded agencies and private therapy service providers fulfill their obligations. These agencies and programs include mental health agencies, local education agencies, health care facility providers, private health insurance, trust funds, and Medi-Cal or Medicare.
• The purchase of any service must be an effective use of public funds, both clinically and fiscally.
• For individuals receiving early intervention services, children in public school programs, and those who reside in health care facilities, services (health care and or therapies including behavior intervention) are expected to be a part of the individual’s program, rather than as a separately funded service.
• TCRC cannot fund any service that is considered experimental, optional or elective in nature.
• If another publicly funded agency or private health insurance denies a service, the denial will be appealed. TCRC may authorize funding for a service during the appeal process if the planning team determines that the service is required to protect the health and safety of a person served by the regional center, or that a prolonged wait for the service will have an irreversible impact on that individual’s health and safety.
• It is the financial responsibility of persons served by the regional center or their families to pay premiums and meet any required deductibles. Funding of copayments or coinsurance will be considered by the IPP planning team.
• TCRC recognizes that some individual needs are unique and may require an exception. Exception requests will be made through the planning team